Nurses Union: NARH Viable as Full-Service Hospital

NORTH ADAMS, Mass. — Massachusetts Nurses Association is unveiling a report at Tuesday's weekly community meeting that it says proves a full-service hospital can survive in rural North Berkshire.

Backers of the "Save Our Hospital" community group, including members of the former health-care system's union chapters of MNA and 1199SEIU, have been meeting each Tuesday evening at 5 p.m. at the American Legion since the closure of the North Adams Regional Hospital on March 28.

MNA officials say reviews of NARH's records posted at the state Center for Health Information and Analysis show that the hospital's demise was not because of losses in patient service care.

"NBH finances shows that NARH made millions of dollars on outpatient, inpatient, and Emergency Department services between 2000 and 2012," states the report. Over 10 years, according to the report, the hospital never made less than $4.3 million annually in profit and averaged more than $9 million.

Northern Berkshire Healthcare's financial struggles have been reported for a number of years. The non-profit invested heavily in renovations and expansion of services in the mid-1990s and early part of the century, taking on tens of millions in debt. A few years ago, it also acquired Northern Berkshire Family Practice largely to prevent the loss of further primary-care physicians in the area.

The health system entered Chapter 11 bankruptcy in 2011. Officials with the health system frequently pointed to an intransigence with its bondholders in restructuring its debt, changes in insurance payments and the higher poverty level (along with lower Medicaid reimbursements) within North Berkshire as impediments to financial health. The more recent rejection of a Critical Care Access designation was considered a nail in the coffin.

MNA says the health system's eagerness to take on debt spelled its doom, not the operations of the hospital — low federal insurance reimbursements notwithstanding.

Medicaid and Medicare payments made up 65 percent of its payers, below state average. The other Western Massachusetts "Disproportionate Share Hospitals," or those hospitals serving higher-than-average poverty areas, had higher numbers of payers on M&M and lower direct payments from patients and insurance than NARH.

"In short, it has been Northern Berkshire Healthcare's decisions to acquire more and more debt. Between 1996 and 2004, Northern Berkshire Healthcare assumed nearly $65 million in debt through revenue bonds issued by MHEFA/MassDevelopment," states the report.

The largest part of the debt, as previously reported, was the purchase and operations losses of Sweetwood and Sweet Brook care and retirement centers in Williamstown. Both facilities were sold off in 2010 for $7 million. The losses for that venture are estimated at more than $20 million.

"It appears that, while patient care services did not contribute to NBH's financial distress and were, in fact, a consistent source of revenue year after year, Northern Berkshire Healthcare sought to remedy its indebtedness by making cuts to those very services," claims the report.

Berkshire Medical Center is in the process of restoring emergency services within the hospital in a deal struck between NBH's bankruptcy court-appointed trustee, the bondholders and the state. The Pittsfield medical facility has also proffered an initial bid on NBH's current properties, which include the doctor's group and building, Visiting Nurse Association and the hospital and its grounds.

BMC officials, however, have been cautious about making any statements about opening anything other than departments necessary to the operations of a satellite emergency facility.

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This is about what I suspected - and absolutely infuriating.

Executives came in, raided the place, and parachuted out. They are on to their next venture, while North Adams might never recover from this blow. And this to the hospital that we, the people, originally built.

This quote really sums it up:

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"It appears that, while patient care services did not contribute to NBH's financial distress and were, in fact, a consistent source of revenue year after year, Northern Berkshire Healthcare sought to remedy its indebtedness by making cuts to those very services," claims the report.

Editor: There really wasn't anything for executives to "raid." Rather, the nurses union is claiming the significant debt incurred by the entire health system was continually offset by cuts on the hospital side and that without the debt, the hospital would be viable.